Headaches / Head Pain

Who has never suffered from headaches? This is a very common symptom among healthy adults. When should it be a concern? When should you seek consultation? Who can help you?

Simply defining such a condition can be a challenge for healthcare professionals. How do you differentiate a migraine from a headache? And how do you even distinguish the different types of headaches (tension, vascular, cervicogenic…)?

First, there are three types of primary headaches: migraine, tension-type headache, and trigeminal autonomic cephalalgias. Here is a table of their respective symptoms:

Characteristics	Migraine	Tension	Trigeminal
Duration	Fairly consistent for the individual, 4–72h	30 min to 7 days	Several days to a few months
Location	Unilateral (can sometimes switch sides)	Bilateral	Unilateral on the cheek, jaw, teeth, gums, lips (less often eye or forehead)
Description	Pulsating	Tightness, pressure, non-pulsating	Electric shocks, flashes of pain, burning, spasms
Intensity	Strong, limiting ADLs	Mild to moderate	Intense
Nausea & Vomiting	Present	Mild or absent	Absent
Photophobia & Phonophobia	Present	Mild or absent	Absent
Other Symptoms	May or may not be preceded by aura	—	—

There are also several types of secondary headaches, including those related to trauma to the head or neck, as well as cervicogenic headaches (originating from the neck). Here is a summary table:

Characteristics	Cervicogenic
Duration	Very variable
Location	Unilateral (never changes sides)
Description	Non-throbbing, fluctuating but continuous pain
Intensity	Moderate to severe
Nausea & Vomiting	Sometimes present
Photophobia & Phonophobia	Rare
Other Symptoms	Worsened by neck movement, uncomfortable postures; may radiate to the shoulder on the same side

In physiotherapy, we are certainly equipped to treat tension-type and cervicogenic headaches. For migraines and trigeminal neuralgia, it is important to work closely with the treating physician to adjust medication and optimize therapy.

Physiotherapy interventions aim to improve the biomechanics of the cranio-vertebral and cervical regions, release tight muscles, strengthen stabilizing muscles, and optimize the individual’s posture and environment. A home exercise program tailored to your current condition is also a key element in headache rehabilitation.

Of course, the goal of this process is not only to relieve pain but also to prevent recurrence of future episodes.

References:

[1] https://www.mayoclinic.org/diseases-conditions/trigeminal-neuralgia/symptoms-causes/syc-20353344

[2] https://ichd-3.org/wp-content/uploads/2019/06/ICHD3-traduction-fran%C3%A7aise-VF-%C3%A0-publier.pdf

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